Fibromyalgia

Definition

• Generalized pain hypersensitivity syndrome
• Lower threshold for the perception of sensation in general

Etiology

• Long-standing pain, often related to cervical or lumbar strain
• Sleep disturbance, including alpha intrusions, sleep apnea, and restless leg syndrome
• Psychiatric disorders
• Viral infection, often overlapping with chronic fatigue syndrome

Clinical Manifestations

• Often correlates with IBS, irritable bladder, visual/auditory hypersensitivity
• Classical tender points correlate most to cervical and lumbar strain etiology

Investigations

• Labs
  • Routine, including inflammatory markers, to rule out rheumatologic disorder
• Other
  • Sleep study for restless leg and sleep apnea

Management

• Treat the contributory cause
• Cervical and lumbar strain
  • Core strengthening
  • Contoured pillow
• Alpha intrusions during sleep: amitriptyline 10mg po HS
• Sleep apnea or restless leg: treat
• Psychiatric issues: CBT and medications
• Viral infection: watchful waiting